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HelpTest Code SRAU Serotonin Release Assay, Unfractionated Heparin, Mass Spectrometry, Serum
Shipping Instructions
Specimen should be frozen if shipped or stored for longer than 48 hours.
Specimen Required
Patient Preparation:
1. Specimen should be collected from a fasting (preferred, but not required) patient during an episode of suspected heparin-induced thrombocytopenia.
2. Patient should not be on ticagrelor (Brilinta) as this may interfere with the assay, yielding a false-negative result.
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Red top (serum gel/SST are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. After collection, specimen should sit at ambient temperature for a minimum of 1 hour in order to clot completely.
2. Centrifuge and aliquot serum into a plastic vial.
Specimen Stability Information: Frozen (preferred) 2 years/Refrigerate 7 days
Useful For
Detecting heparin-dependent platelet activating antibodies implicated in the pathogenesis of heparin-induced thrombocytopenia
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Serotonin Release Assay, UFH, MS, SSpecimen Type
Serum RedSpecimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Frozen (preferred) | ||
| Refrigerated | 7 days | ||
Reference Values
Low Heparin Serotonin Release: <20%
High Heparin Serotonin Release: <20%
Serotonin Release Assay Result: Negative
Interpretation
In a negative serotonin release assay (SRA), patient serum induced serotonin release of below 20% from normal donor platelets in presence of low concentration of unfractionated heparin (UFH) (0.1U/mL) regardless of the serotonin release with high concentration of UFH (100 U/mL).
In a positive SRA, patient serum induced serotonin release of 20% or more from normal donor platelets in presence of low concentration of UFH (0.1U/mL). This release is inhibited in presence of high concentration of UFH (100 U/mL) and falls below 20%.
In an indeterminate SRA, patient serum induced serotonin release of 20% or more from normal donor platelets in presence of low concentration of UFH (0.1U/mL) and high concentration of UFH (100 U/mL). Indeterminate results can occur due to non-heparin dependent antibodies (eg, human leukocyte antigen antibodies). Occasionally some indeterminate results may show greater than 50% inhibition of serotonin release from normal donor platelets in presence of high concentration of UFH (100 U/mL) compared to low concentration of UFH (0.1U/mL), which is suggestive for heparin-induced thrombocytopenia in the right clinical context.
Table. Results and Interpretation
|
Low heparin release % |
High heparin release % |
Interpretation |
|
<20% |
<20% |
Negative |
|
<20% |
≥20% |
Negative |
|
≥20% |
<20% |
Positive |
Clinical Reference
1. Warkentin TE, Arnold DM, Nazi I, Kelton JG. The platelet serotonin-release assay. Am J Hemtol. 2015;90(6):564-572. doi:10.1002/ajh.24006
2. Minet V, Dogne JM, Mullier F. Functional assays in the diagnosis of heparin-induced thrombocytopenia: a review. Molecules. 2017;22(4):617. doi:10.3390/molecules22040617
3. Sono-Koree NK, Crist RA, Frank EL, Rodgers GM, Smock KJ. A high-performance liquid chromatography method for the serotonin release assay is equivalent to the radioactive method. Int. J Lab Hematol. 2016;38(1):72-80. doi:10.1111/ijlh.12442
Day(s) Performed
Monday through Friday
Report Available
1 to 3 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
82542
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| SRAU | Serotonin Release Assay, UFH, MS, S | 50736-8 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 616230 | Low Heparin Serotonin Release | 50728-5 |
| 616231 | High Heparin Serotonin Release | 50727-7 |
| 616232 | Serotonin Release Assay Result | 66488-8 |
| 616233 | Interpretation | 50733-5 |
| 616234 | Comment | 77202-0 |
| 616235 | Disclaimer | 62364-5 |
Forms
If not ordering electronically, complete, print, and send a Coagulation Test Request (T753) with the specimen.